Narrative Therapy and the Practice of Externalization

JST INSTITUTE Blog Part 1 – Posted by Caroline

Externalization – or the practice of externalizing – is a concept most commonly associated with postmodern, social constructivist approaches to therapies. The practice of externalizing is not to be confused with externalizing behaviors, a construct referring to behavior problems manifested in children’s outward behavior and reflecting the child negatively acting on their environment (Eisenberg et al, 2001). Postmodernism, central to the definition of externalization is interested in ‘meaning’ rather than fact and postulates that there is no ‘objective’ truth (Walter & Peller, 1996).

According to Freedman & Combs (1996), fundamental to the postmodern worldview is the assumption that realities are socially constructed and constituted through language. Concerned with how problems are constructed and maintained, this view has resulted in approaches to therapy that have given rise to more collaborative, resource-focused conversations between therapists and clients. These approaches operate on the important premise that the ‘person is NOT the problem; the problem is the problem’, most commonly reflected in solution-focused therapy (de Shazer, 1985) and narrative therapy (Eron & Lund, 1996; Morgan, 2000; White, 1989). Also fundamental to these approaches is the view that language is creational rather than representational (Walter & Peller, 1996). Language is therefore more than a definition of a thing or a phenomenon; it can also influence and/ or create reality. In that context, externalizing the problem became an effective way to separate the person from the problem in order to create change by language the problem as ‘separate’ from the person.

Although the practice of externalization has been used by a number of collaborative, strength-based approaches, it is through the work of Michael White and David Epston (1990), co-founders of narrative therapy, that the concept of externalizing has been most developed, both as a practice concept and as a therapeutic stance. This therapeutic stance refers to narrative therapy as a way of working with people, which centers them as expert in their own life, and assumes they have the resources, skills, competencies, values, and abilities to assist them in reducing the effect of the problems on their lives. Narrative therapy, above all, aims to understand problems and their effect on people’s lives and identities (Morgan, 2000, White & Epston, 1990). Externalization is the foundation of most, if not all, narrative conversations (Morgan, 2000) and refers specifically to a practice in which a problem is spoken about in “… ways that situate it separately from the person and their identity” (Morgan, 2000, p.18). The co-founders of narrative therapy espouse that definition and further clarify:

In this process, the problem becomes a separate entity and thus external to the person or relationship that was ascribed as the problem. Those problems that are considered to be inherent, as well as those relatively fixed qualities that are attributed to persons and to relationships, are rendered less fixed and less restricting. (White & Epston, 1990, p.38)

The practice of externalization assists clients by locating the problem not within themselves, as they might originally present it, but as a product of broader social, political, cultural influences that have participated, over time, in its construction. This linkage between problems, identity, and broader social context is a key aspect in the concept of externalization, and it has strongly influenced the development of the practice of externalization in narrative therapy. The concept of identity itself is a fairly recent social construct. As put forth by Fearon (1999):

Although historically, it derives most of all from Erik Erikson’s work in the 1950s, under the influence of postmodernism and debates over multiculturalism, the late 1980s and 1990s found historians, anthropologists, and most of all humanities scholars relying ever more heavily on ‘identity’ as they explored the cultural politics of race, class, ethnicity, gender, sexuality, citizenship, and other social categories” (p. 35-36).

Therefore, in order to appreciate the theoretical underpinnings of the practice concept of externalization, it is essential to embrace a ‘paradigm shift’, which includes assumptions from a broad range of philosophical, social and anthropological theories. In this context, externalization is not merely a technique or method, rather it is a “… language practice that shows, invites, and evokes generative and respectful ways of thinking about and being with people who are struggling to develop the kind of relationships they would prefer to have with the problems…” affecting them (Roth & Epston, 1996a, p.149).

References

de Shazer, S. (1985). Keys to solution in brief therapy. Markham, ON: Penguin Books

Eisenberg, N., Cumberland, A., Spinrad, T. L., Fabes, R. A., Sheppard, S. A., Reiser, M., Murphy, B. C., Losoya, S. H., & Guthrie, I. K. (2001). The relations of regulation and emotionality to children’s externalizing and internalizing problem behavior. Child Development, 72 (4), pp. 1112-1134. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1676340/

Eron, J. B., & Lund, T. W. (1996). Narrative solutions in brief therapy. New York, NY: The Guilford Press.

Fearon, J. D. (1999). What is identity (as we now use the word)? Unpublished manuscript. Stanford, CA: Stanford University. Retrieved from www.stanford.edu/~jfearon/papers/iden1v2.pdf

Freedman, J., & Combs, G. (1996). Narrative therapy: the social construction of preferred realities. New York, NY: W.W. Norton.

Morgan, A. (2000). What is narrative therapy? An easy-to-read introduction. Adelaide, South Australia: Dulwich Centre Publications.

Roth, S., & Epston, D. (1996a). Consulting the problem about the problematic relationship: An exercise for experiencing a relationship with an externalized problem. In M. Hoyt (Ed.), Constructive therapies: Volume 2, (pp. 148-162). New York, NY: Guilford.

Walter, J. L., & Peller, J. E. (1996). Rethinking our assumptions: Assuming anew in a postmodern world. In S. D. Miller, M. A. Hubble, & B. L. Duncan (Ed.), Handbook of solution-focused brief therapy, (pp. 9-26). San Francisco, CA: Jossey-Bass Inc.

White, M. (1989). Selected papers. Adelaide, Australia: Dulwich Centre Publications

White, M., & Epston, D. (1990). Narrative means to therapeutic ends. W.W. Norton & Company.